title: Single incision versus conventional laparoscopic cholecystectomy outcomes: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Previous meta-analyses that compared the outcome of SILC and CLC have not presented consistent conclusions. This meta-analysis was performed after adding many recent RCTs, to clarify this issue.
  
  
  METHODS
  Relevant articles published in English were identified by searching PubMed, Embase, Web of Knowledge, and the Cochrane Controlled Trial Register from January 1997 to February 2013. Reference lists of the retrieved articles were reviewed to identify additional articles. Primary outcomes (postoperative pain scores, cosmetic score, and length of incision) and secondary outcomes (operating time, blood loss, conversion rates, postoperative complications, postoperative hospital stay, time to initial oral intake, and time to resume work) were pooled. Quantitative variables were calculated using the weighted mean difference (WMD), and qualitative variables were pooled using odds ratios (OR).
  
  
  RESULTS
  25 appropriate RCTs were identified from 2128 published articles. 1841 patients were treated, 944 with SILC and 897 with CLC. SILC was superior to CLC in cosmetic score (WMD = 1.155, P<0.001), shorter length of incision (WMD = -3.285, P = 0.029), and postoperative pain within 12 h (VAS in 3-4 h, WMD = -0.704, P = 0.026; VAS in 6-8 h, WMD = -0.613, P = 0.010). CLC was superior to SILC in operating time (OT) (WMD = 13.613, P<0.001) and need of additional instruments (OR = 7.448, P<0.001). Other secondary outcomes were similar.
  
  
  CONCLUSIONS
  SILC offered a better cosmetic result and less postoperative pain for patients with uncomplicated cholelithiasis or polypoid lesions of the gallbladder. However, SILC was associated with a longer OT and required additional instruments.
authors.affiliation: Department of General Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
authors.forename: Liangyuan
authors.initials: L
authors.lastname: Geng
authors.forename: Changhua
authors.initials: C
authors.lastname: Sun
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Bai
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods* / Q000534:rehabilitation; D002769:Cholelithiasis / Q000601:surgery*; D016206:Databases, Bibliographic; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016017:Odds Ratio; D061646:Operative Time; D010149:Postoperative Pain / Q000503:physiopathology / Q000517:prevention & control*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome